Purpose of Evaluation:
 Education  Employment 
Immigration  Licensing/Certification(We do not provide evaluation for Registered
Nurses or Medical Doctors for Licensing. You have to apply directly to
Licensing Boards)

1. Name: _____________________________________________________________________(Family name as it appears on
your
documents)
(First)
(Middle)

IUL will also officially translate, certify,
and
notarize your documents for a fee of $75.00 per document  × ____ documents.
IUL will issue a frameable (8.5” x 11”) short evaluation certificate
for
$45.00 .

I am enclosing $_____________________.

Affirmations:I hereby affirm that a) the information provided
by me is correct; b) I agree to the terms herein stated;c) I understand this report is advisory and is
not binding on anyone who uses it; d) I release International
University Line for any liability for damages resulting from the use to
which I, or any agency or institution, puts the evaluation report._________________________________________________________________________(Signature-Applicant or Legal
Representative) (Name,
Printed) (Date)